250 research outputs found
Local neck symptoms before and after thyroidectomy: a possible correlation with gastroesophageal reflux and reflux laryngopharingitis.
No full textP02.25 LOCAL NECK SYMPTOMS BEFORE AND AFTER THYROIDECTOMY: A POSSIBLE CORRELATION WITH GASTROESOPHAGEAL REFLUX AND REFLUX LARYNGOPHARYNGITIS.
Alessia Cusimano1, Achille Mastrosimone2, Eugenio Fiorentino1
1Policlinico Of Palermo, Palermo/ITALY, 2Policlinico Of Palermo, Agrigento/ITALY
Background: Swallowing, voice disorders and throat discomfort are usually reported by patients with a thyroid nodule. it may frequently occur in patients who have undergone uncomplicated TT complain of symptoms such as swallowing disorders, hoarseness, a sensation of strangling or of a lump in the neck, a cough and sore throat, all usually attributed to oro- tracheal intubation. Swallowing, voice and throat discomfort should thus be in some way related to the mechanical effects of nodular goiter or to thyroidectomy; it has never been suggested that the same symptoms might refer to a different concomitant medical problem with an overlapping clini- cal presentation. Reflux laryngopharyngitis is the most frequent caused by the laryngopharyngeal reflux (LPR), a term which refers to the backflow of gastric juice into the laryngopharynx. LPR has been considered one of the atypical clinical presentations of gastroesophageal reflux (GER) affecting the larynx and pharynx; several otolaryngologists maintain that LPR differs from GER and concerns reflux in otolaryngology patients more often in the absence of gastrointestinal symptoms.
Methods: in a period of 6 months, 144 patients undergone to TT, interviwed according to the Reflux Symptome Index, investigated through videolaryn- goscopy and videofluoroscopic swallowing studies
Results: 3 months after surgery, swallowing and voice disorders and throat discomfort symptoms persisted in a large number of patients, associated with the laryngopharyngitis revealed by the findings at VLS and alterations at VFSS.
Discussion: this is the first study correlating local neck symptoms in patients with non-toxic nodular goiter to refextra-esophageal reflux, a new hypothesis.
Disclosure: All authors have declared no conflicts of interest
Gastrooesophageal reflux and "Epileptic" attacks: casually associated or related? Efficiency of antireflux surgery, a case report
No full textP02.30 GASTRO-OESOPHAGEAL REFLUX AND “EPILEPTIC” ATTACKS: CASUALLY ASSOCIATED OR RELATED? EFFICIENCY OF ANTIREFLUX SURGERY A CASE REPORT
Achille Mastrosimone1, Alessia Cusimano2, Silvia Marino2,
Gianni Pantuso2, Eugenio Fiorentino2
1Policlinico Of Palermo, Palermo/ITALY, 2University Of Palermo, Palermo/ITALY
Background: Although a possible link between gastro-oesophageal reflux disease (GORD) and obstructive sleeping apnoea has already been reported in the literature, there has never been any suggestion of an association with epilepsy, and epileptic attacks have not so far been included among gastro- oesophageal reflux disease symptoms.
Methods: We report the case of a patient with gastro-oesophageal reflux disease associated with a sliding hiatus hernia, a short oesophagus and oesoph- agitis, who for the last ten years had not only presented the typical symptoms of gastrooesophageal reflux, but also symptoms of obstructive sleep apnoea and epileptic- like attacks occurring occasionally and only during sleep.
Results: Partial posterior fundoplication was performed and considerably reduced the reflux symptoms, and in addition brought about a drastic decrease in the number of epileptic-like attacks.
Discussion: Our case suggests that epileptic-like episodes in patients with obstructive sleeping apnoea may well be linked to the simultaneous presence of GORD associated with hiatus hernia, and surgical treatment of GORD may bring about an improvement of the neurological problems.
Disclosure: All authors have declared no conflicts of interest
A Minor Modification of Lichtenstein Repair of Primary Inguinal Hernia: Postoperative Discomfort Evaluation.
No full textThe aim of this study was to evaluate the usefulness of a modification of the Lichtenstein hernioplasty procedure by evaluating its impact on postoperative discomfort. From December 1999 to May 2006, the Lichtenstein inguinal hernioplasty was performed in 406 patients with noncomplicated unilateral inguinal hernia. During reconstruction, the mesh was fixed to the inguinal canal floor without stitching its upper margin to the internal oblique muscle. Control of postoperative pain proved to be satisfactory; 72 hours after surgery, 26.1 per cent of patients no longer felt any pain, whereas 54.4 per cent had slight pain without the need for painkillers; on Day 7, 92.8 per cent felt no pain at all. After 10 days, 86.7 per cent of those with sedentary jobs were able to return to work, whereas 79.1 per cent of those with heavier jobs resumed work in 11 to 15 days. Our modification of the original Lichtenstein procedure permitted us to obtain satisfactory results with regard to the control of postoperative chronic pain and a rapid reprisal of normal working activity
Posthumanistyczny Inny, czyli wyzwania dla współczesnej humanistyki. Szkic wokół teorii Achille Mbembe
No full text Posthumanistic Another, or challenges for contemporary humanities: Sketch around the theory of Achille MbembeThe text is a critical essay about Achille Mbembe’s poshumanistic theory of identity and answers the question of why we should read about postcolonial theory today, adjusting it to local European relations. The author proposes a specific kind of reading Mbembe’s essay as a call to create an involved identity. Involved identities are a form of resistance against European and many other authorities. Posthumanistic Another, or challenges for contemporary humanities: Sketch around the theory of Achille MbembeThe text is a critical essay about Achille Mbembe’s poshumanistic theory of identity and answers the question of why we should read about postcolonial theory today, adjusting it to local European relations. The author proposes a specific kind of reading Mbembe’s essay as a call to create an involved identity. Involved identities are a form of resistance against European and many other authorities
Recovery time and propagation effects of passenger transport disruptions
No full textWe propose a method to evaluate public transport network vulnerability. We study the evolution of the passenger Volume Over Capacity (VOC) ratio throughout the network to measure the spatial and temporal extent of the impacts caused by an unplanned service segment disruption. The VOC ratio provides an indication of the on-board travel comfort, an important level-of-service indicator, as well as reflects the residual capacity for absorbing additional demand. Because of the dynamic nature of public transport systems, disturbances propagate through the network in both time and space. Our modelling approach is able to capture transit system dynamics and quantify the extent to which the network exhibits spillover effects. We apply the method to the case of the rapid public transport system of Stockholm Sweden We demonstrate how the changes in network saturation and the corresponding recovery time can be quantified.Green Open Access added to TU Delft Institutional Repository ‘You share, we take care!’ – Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.Transport and Plannin
Fundoplicatio sec. Nissen videolaparoscopica e metaplasia intestinale in esofago: osservazioni preliminari
No full textThe aim of this preliminary study conducted in a few cases was the retrospective evaluation of the effects of laparoscopic Nissen fundoplication on oesophageal intestinal metaplasia. Seventy-seven patients with hiatal hernia underwent digital videofluorography, endoscopy with biopsies, motility studies and 24-h oesophageal pH-monitoring. On the basis of the results of the diagnostic procedures and considering the patients' ages and response to proton-pump inhibitor treatment, 8 patients underwent laparoscopic Nissen fundoplication; in 5 cases intestinal metaplasia was present at histopathological examination. Two of these had Barrett's oesophagus at endoscopy and intestinal metaplasia was associated with low-grade dysplasia in both at histology; the other 3 did not present a columnar mucosa at endoscopy and 1 had low-grade dysplasia. In all 5 patients, at 1 year postoperative histopathological control, disappearance or decrease of metaplastic epithelium and regression of dysplasia were noted, with excellent results in terms of reflux symptoms at clinical control. On the basis of these preliminary data, it is our opinion that antireflux surgery is not only a suitable treatment in the management of Barrett's oesophagus but also has a favourable effect on intestinal metaplasia regression when a normal oesophageal mucosa is present
Water-siphon test associated to barium study in the diagnosis of Gastro-Esophageal Reflux: a novel statistical approach
No full textKeratin 7 expression as an early marker of reflux-related columnar mucosa without intestinal metaplasia in the esophagus
No full textBACKGROUND: The role of Barrett esophagus in carcinogenesis is widely accepted, but the significance of esophageal columnar mucosa without histological intestinal metaplasia, known as columnar-lined esophagus, is debated. MATERIAL/METHODS: We studied 128 patients free of Helicobacter pylori with reflux-related symptoms and columnar mucosa in the esophagus at endoscopy, 106 patients with Barrett esophagus (referred to as the Barrett group) and 22 patients without intestinal metaplasia (columnar group). Samples from 20 subjects free of H. pylori were used as controls. Immunostaining for keratin 7 (KRT7), keratin 20 (KRT20), caudal type homeobox 2 (CDX2), mucin 2, oligomeric mucus/gel-forming (MUC2), and tumor protein p53 (TP53) was assessed. RESULTS: Samples taken 1 cm above the gastroesophageal junction showed KRT7 staining in all cases in the Barrett and columnar groups and none in the control group. Immunostaining for TP53 was absent in the control group, and more frequent in the columnar group (7, 31.8%) compared with the Barrett group (14, 13.2%, P=0.033). In the columnar group, low grade dysplasia and TP53 expression was seen in 7 of 22 biopsy specimens (31.8%) at baseline and in 4 additional specimens after 2 years, for a total of 11 specimens (50.0%). CONCLUSIONS: The expression of KRT7 might help to explain the pathological, reflux-related nature of columnar-lined esophagus, as aberrant expression in a very early stage of the multistep Barrett esophagus progression. Expression of KRT7 may occur in basal glandular cells as a result of their multipotentiality and susceptibility to immunophenotype changes induced by reflux
Gastro-oesophageal reflux and "epileptic" attacks: casually associated or related? Efficiency of antireflux surgery. A case report
No full textAlthough a possible link between gastro-oesophageal reflux disease (GORD) and obstructive sleeping apnoea has already been reported in the literature, there has never been any suggestion of an association with epilepsy, and epileptic attacks have not so far been included among gastro-oesophageal reflux disease symptoms. We report the case of a patient with gastro-oesophageal reflux disease associated with a sliding hiatus hernia, a short oesophagus and oesophagitis, who for the last ten years had not only presented the typical symptoms of gastrooesophageal reflux, but also symptoms of obstructive sleep apnoea and epileptic-like attacks occurring occasionally and only during sleep. Partial posterior fundoplication was performed and considerably reduced the reflux symptoms, and in addition brought about a drastic decrease in the number of epileptic-like attacks. Our case suggests that epileptic-like episodes in patients with obstructive sleeping apnoea may well be linked to the simultaneous presence of GORD associated with hiatus hernia, and surgical treatment of GORD may bring about an improvement of the neurological problems
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